K Thiele1, D Phillips2, D Carroll3,, R Watson-Brown4, B Mariyappa Rathnamma5, H Stalewski6, L Porrett7, M Parkinson8

1 Dept of Paediatric surgery, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814, kurt.thiele@health.qld.gov.au
2 Dept of Occupational therapy, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814, Debra.Phillips@health.qld.gov.au
3 Dept of Paediatric surgery, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814,
Daniel.Carroll@health.qld.gov.au
4 Dept of Occupational therapy, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814, Rebecca.watson-brown@health.qld.gov.au
5 Dept of Paediatric surgery, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814,
nhanu.mariyapparathnamma@health.qld.gov.au
6 Dept of Paediatric surgery, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814,
harry.stalewski@health.qld.gov.au
7 Dept of Paediatric surgery, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814,
liesel.porrett@health.qld.gov.au
8 Dept of paediatric nursing, Townsville Hospital and Health Service, 100 Angus Smith drive, Douglas, Townsville QLD 4814,
michelle.parkinson@health.qld.gov.au

Aim

To examine the accuracy of photograph based burns assessment in people with darker skin (Fitzpatrick IV-VI).

Introduction

The North Queensland Paediatric Burns Service (NQPBS), located at The Townsville Hospital (TTH), is the only tertiary burns referral centre in North Queensland and manages burns from an extremely large geographical area including the Torres Strait. This creates challenges in accuracy of triage, acceptance and timely transfer of children with acute burns.

Currently digital photography and referral site burn severity assessment are the primary methods of assessing burn severity and subsequent transfer. Although a useful adjunct to the burns injury assessment1-3, poor photograph quality, poor referral site estimations of burn size and depth, and large numbers of darker skinned patients (Fitzpatrick IV-VI)4, hamper accurate burns severity assessment resulting in gross underestimation of burns severity.

Methods

In a retrospective analysis of the charts of patients with darker skin types, we examine the accuracy of burn severity analysis using digital photography and referral centre estimation and compare it to the estimation of burn severity at the NQPBS.

Conclusion

Although the data supports the use of photography as an adjunct to burn severity assessment, there are limitations in using it as the sole modality for assessing burns, specifically in people with dark skin where there is a tendency to underestimate burn severity. For this reason burns assessment in a tertiary referral centre is imperative to prevent underestimation and under treatment of large burns.

Key Words
Burns, Burns severity assessment, Telemedicine, Photography, Dark Skin, Fitzpatrick IV-VI